MR. Adam L Hickenbotham, OD

NPI #1063462778 in Provo, Utah

Provider Information

NPI Number: 1063462778
Entity Type: Individual
Name: MR. Adam L Hickenbotham, OD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: May 11, 2006
Last Updated: Dec 3, 2024

Practice Location

Address: 122 E 1700 S BLDG 3
City: Provo
State: Utah
ZIP Code: 84606-5644
Phone: (385) 248-5550

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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